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Medical Advancements: Victorian Era Prosthetics

As is usual for any of our tea-filled gabbing sessions, the discussion turned towards science and technology; in this case, prosthetics in the Victorian era. It began with a discussion of the prosthesis portrayed in Boardwalk Empire on the soldier Richard Harrow, who covers his scars and missing eye with a tin plated facsimile of his own face. While facial prostheses of this type were prevalent in World War I (an excellent article about the early days of aesthetic plastic surgery performed in the attempt to recreate these soldiers wounded faces can be found here at the Smithsonian magazine website), I was curious as to the Victorian contribution to this form of medicine.

In 1800, James Potts improved upon current prosthetic limb mechanics (which were basically variations on a peg/wooden leg theme) with his “Anglesey” leg design, which was named for the Marquess of Anglesey after he was injured in the Battle of Waterloo in 1815. This consisted of “a wooden shaft and socket, steel knee joint, and an articulated foot with artificial cords or catgut tendons that connected knee flexion with foot flexion. The tendon system caused the first incorporation of dorsiflextion and plantar flexion of the foot with accordance to knee movement, an aspect of prosthetic feet production that is used and desirable today.” It went through subsequent modifications and improvements in both the UK and the US; A. A. Marks in 1856, gave it knee, ankle and toe movements and an adjustable articulation control.

An excellent article on War and Prosthetics relays the following realistic insight from Stewart Emmens, the curator of Community Health at the Science Museum in London: “Still, until the mid-20th century, such replacement limbs were financially inaccessible to the many working class individuals who needed them. A Victorian agricultural laborer who lost his lower arm in an accident was probably more likely to get the local blacksmith to make a hooked prosthesis for him than to check the catalog of the nearest limb manufacturer,” says Emmens. “These were relatively expensive items, and given that any gripping, flexing, or thumb-to-finger movements would depend on a system of joints, cords, and shoulder harnesses, they were not necessarily that practical for working people either.”

Whether or not they could afford a newfangled arm or leg, amputees got on with their lives, learning to cope with their disabilities and inventing their own solutions. Some became so comfortable using temporary limb replacements that they never attempted to find a fully functioning prosthetic. Others fashioned their own devices from available materials, making necessary repairs as time went on.”

Such a device is shown here, which clearly favors function over form or aesthetics. According to the museum, it was made by Chas A Blatchford & Sons, a company that manufactured and designed prosthetic limbs since 1890.

This arm, however, made in the early 1900s, shows greater complexity and attention to form as well as function: “A 16 year-old girl with a below-the-elbow amputation used this prosthetic arm. It is made of wood, leather and textile. The arm suspends from the body by a leather shoulder saddle and single strap that passes under the opposite underarm. The forearm connects to a lace-up arm corset by steel struts. It provided the wearer with a range of movements. The small wooden hand has fully articulating fingers and a rotating wrist. There is also a small hook fitted in the palm with three locking positions. This is for carrying items such as bags, or grasping utensils such as cutlery.”

In contrast to the beautifully crafted arm above, there’s this nightmare, also brought to us courtesy of the London Science Museum: “Made from steel and brass, this unusual prosthetic arm articulates in a number of ways. The elbow joint can be moved by releasing a spring, whereas the top joint of the wrist allows a degree of rotation and an up-and-down motion. The fingers can also curl up and straighten out. The leather upper arm piece is used to fix the prosthesis to the remaining upper arm. The rather sinister appearance of the hand suggests the wearer may have disguised it with a glove.”

I sincerely hope so. I’d correct the above official description thusly: “Made of steel and brass AND THE BLOOD OF 6 KITTENS AND THE HEART OF SNOW WHITE” but then again, that’s likely a reason why they’d think twice about hiring me to do their PR. I kid, of course, but I appreciate the deadly beauty and elegant technological construction of such a prosthesis. This particular image apparently made its Internet rounds a few years ago, with the majority of reactions largely falling into one of two categories: 1) “OMG WTF TERMINATOR STEAMPUNK CYBORG DYSTOPIA” and 2) “Wait, that’s from the 19th century??? That looks like something we’d make today.” Here, I think, is where the real discourse lies; while amputations came into practice as far back as 4 BCE, the advent of modern prosthetic technology seems to have come into being from the early 1800s and gradually evolved through WWI, which itself radically changed the landscape of modern medicine with the increased need for rapidly advancing surgical improvements and complex prosthetic devices.

As the Victorians industrialized, the relationship between man and machine began to change. During this time, many doctors, scientists, and engineers were able to use technology to benefit mankind, allowing prosthetic improvement to supplement the gradual anesthetic and surgical improvements that were happening in the field of medicine. It is a credit to these innovators that we were able to move away from simpler devices created from everyday household items to more sophisticated prostheses in order to return mobility and form that had been lost to war, accident, or disease.